Method of radiation delivery to the eye

Abstract

A surgical device for localized delivery of beta radiation in surgical procedures, particularly ophthalmic procedures. Preferred surgical devices include a cannula with a beta radiotherapy emitting material at the distal end of the cannula. The surgical device is particularly suitable for use in the treatment of treat Age Related Macular Degeneration (AMD).

1. A method for delivery of radiation to a sub-retinal region of the eye, comprising:
 detaching a portion of the retina from the sub-retinal region, and  
 exposing the sub-retinal region to ionizing radiation.  
 
   
   
     2. A method in accordance with  claim 1  wherein the sub-retinal region is exposed to radiation for a time period of about 1 minute or more. 
   
   
     3. A method in accordance with  claim 1  wherein the sub-retinal region is exposed to radiation for a time period of about 15 minutes or less. 
   
   
     4. A method in accordance with  claim 1  wherein the sub-retinal region is exposed to radiation for a time period between about 1 minute and about 15 minutes. 
   
   
     5. A method in accordance with  claim 4  wherein the time period comprises a period between about 2 minutes and about 10 minutes. 
   
   
     6. A method in accordance with  claim 1  wherein the ionizing radiation is from a source having an energy sufficient to provide a dose rate of about 50 cGy/sec or more. 
   
   
     7. A method in accordance with  claim 1  wherein the ionizing radiation comprises beta radiation. 
   
   
     8. A method in accordance with  claim 1  wherein the ionizing radiation comprises a therapeutic radiation component. 
   
   
     9. A method in accordance with  claim 8  wherein the therapeutic radiation component comprises essentially pure beta radiation. 
   
   
     10. A method in accordance with  claim 1  wherein the sub-retinal region is exposed to sufficient radiation to treat neovascularization. 
   
   
     11. A method in accordance with  claim 10  wherein the sub-retinal region comprises blood vessels. 
   
   
     12. A method in accordance with  claim 1  wherein the exposing comprises targeting the radiation only at a selected area of the sub-retinal region. 
   
   
     13. A method of  claim 12  wherein the selected area comprises blood vessels. 
   
   
     14. A method in accordance with  claim 1  wherein the exposing comprises providing an ionizing radiation source and positioning the radiation source spaced from the sub-retinal region. 
   
   
     15. A method in accordance with  claim 14  wherein the spacing is about 1 mm or more. 
   
   
     16. A method in accordance with  claim 14  wherein the spacing is about 3 mm or less. 
   
   
     17. A method in accordance with  claim 14  wherein the spacing is between about 1 mm and about 3 mm. 
   
   
     18. A method in accordance with  claim 1  wherein the exposing comprises providing an ionizing radiation source and contacting the sub-retinal region with the radiation source. 
   
   
     19. A method in accordance with  claim 1  wherein the exposing comprises providing an ionizing radiation source and positioning the radiation source so that radiation emitted from the radiation source targets only sub-retinal tissue. 
   
   
     20. A method for treating macular degeneration of the eye, comprising:
 detaching a portion of the retina of the eye to provide access to a sub-retinal region;  
 introducing an ionizing radiation source between the retina and the sub-retinal region; and  
 exposing the sub-retinal region to ionizing radiation from the ionizing radiation source.  
 
   
   
     21. A method in accordance with  claim 20  wherein the sub-retinal region is exposed to the radiation for a time period of about 1 minute or more. 
   
   
     22. A method in accordance with  claim 20  wherein the sub-retinal region is exposed to the radiation for a time period of about 15 minutes or less. 
   
   
     23. A method in accordance with  claim 20  wherein the sub-retinal region is exposed to the radiation for a time period between about 1 minute and about 15 minutes. 
   
   
     24. A method in accordance with  claim 23  wherein the time period comprises a period between about 2 minutes and about 10 minutes. 
   
   
     25. A method in accordance with  claim 20  wherein the radiation source has an energy sufficient to provide a dose rate greater than or equal to about 50 cGy/sec. 
   
   
     26. A method in accordance with  claim 20  wherein the radiation source comprises a beta radiation emitter. 
   
   
     27. A method in accordance with  claim 20  wherein the radiation source comprises a therapeutic radiation component. 
   
   
     28. A method in accordance with  claim 27  wherein the therapeutic radiation component comprises essentially a pure beta radiation emitter. 
   
   
     29. A method in accordance with  claim 20  wherein the sub-retinal region is exposed to sufficient radiation to treat neovascularization. 
   
   
     30. A method in accordance with  claim 29  wherein the sub-retinal region comprises blood vessels. 
   
   
     31. A method in accordance with  claim 20  wherein the exposing comprises targeting the radiation at a selected area of the sub-retinal region. 
   
   
     32. A method of  claim 31  wherein the selected area comprises blood vessels. 
   
   
     33. A method in accordance with  claim 20  further comprising positioning the radiation source spaced from the sub-retinal region. 
   
   
     34. A method in accordance with  claim 33  wherein the spacing is about 1 mm or more. 
   
   
     35. A method in accordance with  claim 33  wherein the spacing is about 3 mm or less. 
   
   
     36. A method in accordance with  claim 33  wherein the spacing is between about 1 mm and about 3 mm. 
   
   
     37. A method in accordance with  claim 20  further comprising contacting the sub-retinal region with the radiation source. 
   
   
     38. A method in accordance with  claim 20  wherein the exposing comprises positioning the radiation source so that radiation emitted from the radiation source targets only the sub-retinal region. 
   
   
     39. A method in accordance with  claim 20  further comprising providing a shield for shielding at least a portion of the radiation source. 
   
   
     40. A method in accordance with  claim 39  wherein the shield and the radiation source are relatively movable so as to allow shielding of the radiation source when desired. 
   
   
     41. A method in accordance with  claim 20  wherein the radiation source is disposed within an elongated cannula having a distal end and the cannula tapers toward the distal end. 
   
   
     42. A method in accordance with  claim 20  wherein the radiation source is disposed within a curved cannula for ease of introducing the radiation source. 
   
   
     43. A method in accordance with  claim 20  wherein the radiation source has a length between about 2 mm and about 6 mm. 
   
   
     44. A method for treating the eye, comprising:
 detaching the macula from a sub-macular membrane;  
 introducing an ionizing radiation source into the vitreous of the eye;  
 directly accessing the sub-macular membrane with the ionizing radiation source; and  
 targeting sub-macular tissue with ionizing radiation from the ionizing radiation source.  
 
   
   
     45. A method in accordance with  claim 44  wherein the sub-macular tissue is targeted with radiation for a time period of about 1 minute or more. 
   
   
     46. A method in accordance with  claim 44  wherein the sub-macular tissue is targeted with radiation for a time period of about 15 minutes or less. 
   
   
     47. A method in accordance with  claim 44  wherein the sub-macular tissue is targeted with radiation for a time period between about 1 minute and about 15 minutes. 
   
   
     48. A method in accordance with  claim 47  wherein the time period comprises a period between about 2 minutes and 10 minutes. 
   
   
     49. A method in accordance with  claim 44  wherein the radiation source has an energy sufficient to provide a dose rate greater than or equal to about 50 cGy/sec. 
   
   
     50. A method in accordance with  claim 44  wherein the radiation source is a beta radiation emitter. 
   
   
     51. A method in accordance with  claim 44  wherein the radiation source comprises a therapeutic radiation component. 
   
   
     52. A method in accordance with  claim 51  wherein the therapeutic radiation component is essentially a pure beta radiation emitter. 
   
   
     53. A method in accordance with  claim 44  further comprising positioning the radiation source spaced from the sub-macular tissue. 
   
   
     54. A method in accordance with  claim 53  wherein the spacing is about 1 mm or more. 
   
   
     55. A method in accordance with  claim 53  wherein the spacing is about 3 mm or less. 
   
   
     56. A method in accordance with  claim 53  wherein the spacing is between about 1 mm and about 3 mm. 
   
   
     57. A method in accordance with  claim 44  further comprising contacting the sub-macular tissue with the radiation source. 
   
   
     58. A method in accordance with  claim 44  wherein the targeting comprises positioning the radiation source so that the radiation emitted from the radiation source targets only the sub-macular tissue. 
   
   
     59. A method in accordance with  claim 44  further comprising providing a shield for shielding at least a portion of the radiation source. 
   
   
     60. A method in accordance with  claim 59  wherein the shield and the radiation source are relatively movable so as to allow shielding of the radiation source when desired. 
   
   
     61. A method in accordance with  claim 44  wherein the radiation source is disposed within an elongated cannula having a distal end and the cannula tapers toward the distal end. 
   
   
     62. A method in accordance with  claim 44  wherein the radiation source is disposed within a curved cannula for ease of introducing the radiation source. 
   
   
     63. A method in accordance with  claim 44  wherein the radiation source has a length between about 2 mm and about 6 mm. 
   
   
     64. A method for the treatment of wet macular degeneration of the eye, comprising:
 providing a radiation source delivery cannula having a distal end and the cannula being tapered toward the distal end;  
 detaching the macula to provide direct access to a sub-macular membrane comprising blood vessels;  
 introducing the distal end of the cannula through the sclera into the interior of the eye;  
 directly accessing the sub-macular membrane with the distal end of the cannula;  
 providing an ionizing radiation source at the distal end of the cannula;  
 positioning the ionizing radiation source between about 1 mm and about 3 mm from the blood vessels; and  
 exposing the blood vessels to sufficient ionizing radiation to treat choroidal neovascularization.  
 
   
   
     65. A method in accordance with  claim 64  wherein the ionizing radiation source is disposed at the proximal end of the cannula before introducing the distal end of the cannula through the sclera into the interior of the eye.